HIV Prevention and Heterosexual African-American Women

  • Gina M. Wingood
  • Christina Camp
  • Kristin Dunkle
  • Hannah Cooper
  • Ralph J. DiClemente


Early in the epidemic, HIV infection and AIDS were diagnosed among relatively few women and female adolescents. Currently, women account for more than 25% of all new HIV/AIDS diagnoses in the USA. Heterosexually acquired HIV/AIDS is the predominant route of transmission for African-American women. Among African-American women diagnosed with HIV/AIDS during 2001–2004, 78% contracted the infection via heterosexual contact.1, 2 Unfortunately, African-American women are being devastated by the HIV/AIDS epidemic. Thus, designing effective HIV prevention programs for this population is crucial. Theoretical frameworks are critical components of HIV prevention programs because they serve as guides for developing the core elements, vignettes, and activities of HIV prevention interventions.


Sexual Division Sexual Assertiveness SISTA Institute Supportive Network Member Macrosocial Factor 


  1. 1.
    Centers for Disease Control & Prevention. Trends in HIV/AIDS diagnoses - 33 states, 2001-2004. Morbidity & Mortality Weekly Report, 2005; 54, 1149-1153Google Scholar
  2. 2.
    Centers for Disease Control & Prevention. HIV/AIDS Surveillance Report, 2004. Atlanta, GA: US Department of Health & Human Services, 2005; vol. 16, pp. 1-46Google Scholar
  3. 3.
    Wingood GM, DiClemente RJ. Application of the theory of gender and power to examine HIV-related exposures, risk factors, and effective interventions for women. Health Education & Behavior, 2001; 27, 539-565CrossRefGoogle Scholar
  4. 4.
    Blankenship KM, Bray SJ, Merson MH. Structural interventions in public health. AIDS, 2000; 4: S11-S21CrossRefGoogle Scholar
  5. 5.
    U.S. Census Bureau. Poverty: 1999. Census 2000 Brief. Issued May 2003Google Scholar
  6. 6.
    Anderson JE, Brackbill R, Mosher WD. Condom use for disease prevention among unmarried U.S. women. Family Planning Perspectives, 1996; 28, 25-28PubMedCrossRefGoogle Scholar
  7. 7.
    Peterson JL, Grinstead OA, Golden E, Catania JA, Kegeles S, Coates TJ. Correlates of HIV risk behaviors in black and white San Francisco heterosexuals: the population-based AIDS in multiethnic neighborhoods (AMEN) study. Ethnicity & Disease, 1992; 2, 361-370Google Scholar
  8. 8.
    Wingood GM, DiClemente RJ. Relationship characteristics associated with noncondom use among young adult African-American women. American Journal of Community Psychology, 1998; 26, 29-53PubMedCrossRefGoogle Scholar
  9. 9.
    Wingood GM, DiClemente RJ. The influence of psychosocial factors, alcohol, drug use on African-American women's high-risk sexual behavior. American Journal of Preventive Medicine, 1998; 15, 54-59PubMedCrossRefGoogle Scholar
  10. 10.
    Wingood GM, DiClemente RJ. Partner influences and gender-related factors associated with noncondom use among young adult African-American women. American Journal of Community Psychology, 1998; 26, 29-51PubMedCrossRefGoogle Scholar
  11. 11.
    Diaz T, Chu SY, Buehler JW, et al. Socioeconomic differences among people with AIDS: results from a multistate surveillance project. American Journal of Preventive Medicine, 1994; 10, 217-222PubMedGoogle Scholar
  12. 12.
    Graves KL, Hines AM. Ethnic differences in the association between alcohol and risky sexual behavior with a new partner: an event-based analysis. AIDS Education and Prevention, 1997; 9, 219-237PubMedGoogle Scholar
  13. 13.
    Fullilove R, Fullilove M, Bowser B, et al. Risk of sexually transmitted disease among black adolescent crack users in Oakland and San Francisco, Calif. Journal of the American Medical Association, 1990; 263, 851-855PubMedCrossRefGoogle Scholar
  14. 14.
    Edlin BR, Erwin KL, Faruque S, et al. Intersecting epidemics: crack cocaine use and HIV infection among inner city young adults. Multicenter Crack Cocaine and HIV Infection Study Team. New England Journal of Medicine, 1994; 24, 1422-1427CrossRefGoogle Scholar
  15. 15.
    Jemmott JB, Jemmott LS, Spears H, Hewitt N, Cruz-Collins M. Self-efficacy, hedonistic expectancies, and condom-use intentions among inner-city black adolescent women: a social cognitive approach to AIDS risk behavior. Journal of Adolescent Health, 1992; 13, 512-519PubMedCrossRefGoogle Scholar
  16. 16.
    Catania JA, Coates TJ, Kegeles S, et al. Condom use in multi-ethnic neighborhoods of San Francisco: the population-based AMEN (AIDS in multi-ethnic neighborhoods) study. American Journal of Public Health, 1992; 82, 284-287PubMedCrossRefGoogle Scholar
  17. 17.
    Nyamathi A, Bennett C, Leake B, Lewis C, Flaskerud J. AIDS-Related knowledge, perceptions, and behaviors among impoverished minority women. American Journal of Public Health, 1993; 83, 65-71PubMedCrossRefGoogle Scholar
  18. 18.
    Sterk C. Fast Lives: Women Who Use Crack Cocaine. Philadelphia, PA: Temple University Press; 1999Google Scholar
  19. 19.
    Sterk.CE. Tricking and Tripping: Prostitution in the Era of AIDS. Putnam Valley, NY: Social Change Press; 2000Google Scholar
  20. 20.
    Wyatt GE. The sociocultural context of African American and White American women's rape. Journal of Social Issue, 1992; 48, 77-91CrossRefGoogle Scholar
  21. 21.
    Wingood GM, DiClemente RJ. The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women. American Journal of Public Health, 1997; 87, 1016-1018PubMedCrossRefGoogle Scholar
  22. 22.
    Wingood GM, DiClemente RJ, Hubbard McCree D, Harrington K, Davies S. Dating Violence and African-American Adolescent Females’ Sexual Health. Pediatrics, 2001; 107, E72PubMedCrossRefGoogle Scholar
  23. 23.
    Miller K, Clark L, Moore JS. Heterosexual risk for HIV among female adolescents: sexual initiation with older male partners. Family Planning Perspectives, 1997; 29, 212-214PubMedCrossRefGoogle Scholar
  24. 24.
    Lyles CM, Kay LS, Crepaz N, et al. Best-Evidence Interventions: Findings from a systematic review of HIV behavioral interventions for US populations at high risk, 2000-2004. American Journal of Public Health, 2007; 97, 133-143PubMedCrossRefGoogle Scholar
  25. 25.
    Ehrhardt AA, Exner TM, Hoffman S, et al. A gender-specific HIV/STD risk reduction intervention for women in a health care setting: short- and long-term results of a randomized clinical trial. AIDS Care, 2002; 14, 147-161PubMedCrossRefGoogle Scholar
  26. 26.
    Sterk CE, Theall KP, Elifson KW. Effectiveness of a risk reduction intervention among African American women who use crack cocaine. AIDS Education & Prevention, 2003; 15, 15-32CrossRefGoogle Scholar
  27. 27.
    Wechsberg WM, Lam WK, Zule WA, Bobashev G. Efficacy of a woman-focused intervention to reduce HIV risk and increase self-sufficiency among African American crack abusers. American Journal of Public Health, 2004; 94, 1165-1173PubMedCrossRefGoogle Scholar
  28. 28.
    DiClemente RJ, Wingood GM, Harrington KF, et al. Efficacy of an HIV prevention intervention for African American adolescent girls: a randomized controlled trial. Journal of the American Medical Association, 2004; 292, 171-179PubMedCrossRefGoogle Scholar
  29. 29.
    Institute of Medicine. Report Brief. No Time to Lose: Getting the Most From HIV Prevention. Washington, DC: National Academies Press; 2001. Available at
  30. 30.
    Prather C. Personal communications regarding progress of CDC disseminating SiSTA, 2005Google Scholar
  31. 31.
    DiClemente RJ, Wingood GM. A randomized controlled social skills trial: An HIV sexual risk-reduction intervention among young adult African-American women. Journal of the American Medical Association, 1995; 274, 1271-1276PubMedCrossRefGoogle Scholar
  32. 32.
    Centers for Disease Control & Prevention. HIV/AIDS Prevention Research Synthesis Project. Compendium of HIV Prevention Interventions with Evidence of Effectiveness. 1999 Google Scholar
  33. 33.
    Wingood GM, DiClemente RJ, Mikhail I, et al. A randomized controlled trial to reduce HIV transmission risk behaviors and STDs among women living with HIV: The WILLOW Program. Journal of Acquired Immune Deficiency Syndromes, 1992; 37, S58-S67CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Gina M. Wingood
    • 1
  • Christina Camp
  • Kristin Dunkle
  • Hannah Cooper
  • Ralph J. DiClemente
  1. 1.Department of Behavioral Sciences and Health EducationEmory University, Rollins School of Public HealthAtlantaU.S.

Personalised recommendations